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Business travel-associated illness: a GeoSentinel analysis.
J Travel Med. 2018 01 01; 25(1)JT

Abstract

Background

Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers.

Methods

GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014.

Results

Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess.

Conclusions

Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement.

Links

Publisher Full Text
ncbi.nlm.nih.gov
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Authors+Show Affiliations

Chen LH
Mount Auburn Hospital, Cambridge, Massachusetts, and Harvard Medical School, Boston, MA, USA.
Leder K
Royal Melbourne Hospital and School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
Barbre KA
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Schlagenhauf P
University of Zürich Centre for Travel Medicine, WHO Collaborating Centre for Travellers' Health, Epidemiology, Biostatistics and Prevention Institute, Zürich, Switzerland.
Libman M
Montreal General Hospital and McGill University, Montreal, Quebec, Canada.
Keystone J
Toronto General Hospital and University of Toronto, Toronto, Ontario, Canada.
Mendelson M
Division of Infectious Diseases & HIV Medicine, Department of Medicine, Groote Schuur Hospital, University of Cape Town, Cape Town, South Africa.
Gautret P
Aix Marseille Université, IHU-Méditerranée Infection, Marseille, France.
Schwartz E
The Chaim Sheba Medical Center, Tel Hashomer, and Sackler Faculty of Medicine Tel-Aviv University, Israel.
Shaw M
Worldwise Travellers Health Centres New Zealand and James Cook University, Australia.
MacDonald S
Medicine and Quality, Interior Health, and University of British Columbia, Kelowna, British Columbia, Canada.
McCarthy A
Ottawa Hospital and University of Ottawa, Ottawa, Ontario, Canada.
Connor BA
The New York Center for Travel and Tropical Medicine and Weill Medical College of Cornell University, New York, NY, USA.
Esposito DH
Division of Global Migration and Quarantine, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Hamer D
Center for Global Health and Development, Boston University School of Public Health, and Boston University School of Medicine, Boston, MA, USA.
Wilson ME
Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, CA, USA.
GeoSentinel Surveillance Network
No affiliation info available

MeSH

AdultAfrica South of the SaharaAgedAsiaCommerceDiarrheaEuropeFemaleHumansMalariaMaleMiddle AgedNorth AmericaOccupational MedicineSentinel SurveillanceSexually Transmitted DiseasesTravelYoung Adult

Pub Type(s)

Journal Article
Multicenter Study
Research Support, Non-U.S. Gov't
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

29462444

Citation

Chen, Lin H., et al. "Business Travel-associated Illness: a GeoSentinel Analysis." Journal of Travel Medicine, vol. 25, no. 1, 2018.
Chen LH, Leder K, Barbre KA, et al. Business travel-associated illness: a GeoSentinel analysis. J Travel Med. 2018;25(1).
Chen, L. H., Leder, K., Barbre, K. A., Schlagenhauf, P., Libman, M., Keystone, J., Mendelson, M., Gautret, P., Schwartz, E., Shaw, M., MacDonald, S., McCarthy, A., Connor, B. A., Esposito, D. H., Hamer, D., & Wilson, M. E. (2018). Business travel-associated illness: a GeoSentinel analysis. Journal of Travel Medicine, 25(1). https://doi.org/10.1093/jtm/tax097
Chen LH, et al. Business Travel-associated Illness: a GeoSentinel Analysis. J Travel Med. 2018 01 1;25(1) PubMed PMID: 29462444.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Business travel-associated illness: a GeoSentinel analysis. AU - Chen,Lin H, AU - Leder,Karin, AU - Barbre,Kira A, AU - Schlagenhauf,Patricia, AU - Libman,Michael, AU - Keystone,Jay, AU - Mendelson,Marc, AU - Gautret,Philippe, AU - Schwartz,Eli, AU - Shaw,Marc, AU - MacDonald,Sue, AU - McCarthy,Anne, AU - Connor,Bradley A, AU - Esposito,Douglas H, AU - Hamer,Davidson, AU - Wilson,Mary E, AU - ,, PY - 2017/06/21/received PY - 2018/01/02/accepted PY - 2018/2/21/entrez PY - 2018/2/21/pubmed PY - 2019/7/30/medline JF - Journal of travel medicine JO - J Travel Med VL - 25 IS - 1 N2 - Background: Analysis of a large cohort of business travelers will help clinicians focus on frequent and serious illnesses. We aimed to describe travel-related health problems in business travelers. Methods: GeoSentinel Surveillance Network consists of 64 travel and tropical medicine clinics in 29 countries; descriptive analysis was performed on ill business travelers, defined as persons traveling for work, evaluated after international travel 1 January 1997 through 31 December 2014. Results: Among 12 203 business travelers seen 1997-2014 (14 045 eligible diagnoses), the majority (97%) were adults aged 20-64 years; most (74%) reported from Western Europe or North America; two-thirds were male. Most (86%) were outpatients. Fewer than half (45%) reported a pre-travel healthcare encounter. Frequent regions of exposure were sub-Saharan Africa (37%), Southeast Asia (15%) and South Central Asia (14%). The most frequent diagnoses were malaria (9%), acute unspecified diarrhea (8%), viral syndrome (6%), acute bacterial diarrhea (5%) and chronic diarrhea (4%). Species was reported for 973 (90%) of 1079 patients with malaria, predominantly Plasmodium falciparum acquired in sub-Saharan Africa. Of 584 (54%) with malaria chemoprophylaxis information, 92% took none or incomplete courses. Thirteen deaths were reported, over half of which were due to malaria; others succumbed to pneumonia, typhoid fever, rabies, melioidosis and pyogenic abscess. Conclusions: Diarrheal illness was a major cause of morbidity. Malaria contributed substantial morbidity and mortality, particularly among business travelers to sub-Saharan Africa. Underuse or non-use of chemoprophylaxis contributed to malaria cases. Deaths in business travelers could be reduced by improving adherence to malaria chemoprophylaxis and targeted vaccination for vaccine-preventable diseases. Pre-travel advice is indicated for business travelers and is currently under-utilized and needs improvement. SN - 1708-8305 UR - https://www.unboundmedicine.com/medline/citation/29462444/Business_travel_associated_illness:_a_GeoSentinel_analysis_ L2 - https://academic.oup.com/jtm/article-lookup/doi/10.1093/jtm/tax097 DB - PRIME DP - Unbound Medicine ER -